Untreated Cancer Pain a ‘Scandal of Global Proportions,’ Survey Shows

[n2doc]

New global study led by ESMO reveals a pandemic of intolerable pain affecting billions, caused by over-regulation of pain medicines

Date : 28 Nov 2013

Lugano, Switzerland –- A ground-breaking international collaborative survey, published today in Annals of Oncology, shows that more than half of the world’s population live in countries where regulations that aim to stem drug misuse leave cancer patients without access to opioid medicines for managing cancer pain.

The results from the Global Opioid Policy Initiative (GOPI) project show that more than 4 billion people live in countries where regulations leave cancer patients suffering excruciating pain. National governments must take urgent action to improve access to these medicines, says the European Society for Medical Oncology, leader of a group of 22 partners that have launched the first global survey to evaluate the availability and accessibility of opioids for cancer pain management.

“The GOPI study has uncovered a pandemic of over-regulation in much of the developing world that is making it catastrophically difficult to provide basic medication to relieve strong cancer pain,” says Nathan Cherny, Chair of the ESMO Palliative Care Working Group and lead author of the report, from Shaare Zedek Medical Center, Jerusalem, Israel. “Most of the world’s population lacks the necessary access to opioids for cancer pain management and palliative care, as well as acute, post-operative, obstetric and chronic pain.”

“When one considers that effective treatments are cheap and available, untreated cancer pain and its horrendous consequences for patients and their families is a scandal of global proportions,” Cherny says.

more

http://www.esmo.org/Press-Office/Press-Releases/ESMO-Press-Release-Untreated-Cancer-Pain-a-Scandal-of-Global-Proportions-Survey-Shows

more casualties of the war on drugs....

[Maraya1969]

1. I found it so endearing that the pharmacist at Walgreens decided that I had been on a certain

drug for too long and SAYS she called my doctor, (he has no remembrance of it and when I told her that she said she spoke with the nurse who had spoken to him) and prescribed me a different drug.

I refused to take this new drug because of a fear of a certain side effect. However a few days ago I took it because I was just suffering too much.

So after sleeping for while my symptoms were:
extremely sore throat of top of the back of my throat
Migraine going from my neck to around my eyes
Vomiting - several times.

I have already registered a complaint with Walgreens about this but I may register another one.

[RC]

2. Time to find another place to get your prescriptions filled.

[TeeYiYi]

21. Pow!...

...Right in the kisser!!!



TYY

[ErikJ]

3. Oxycontin is gateway to heroin addiction in the US

I saw a documentary on oxycontin and heroin abuse a while back and lots of pains and injuries treated with oxycontin lead to heroin addiciton. Quite a scary documentary.
My friend is recovering from pancreas cancer operation a month ago and I warned him about this and is refusing oxy now. He says he doesnt like it anyway cuz it makes him too tired.

[Ed Suspicious]

4. Aleviating pain of endstage cancer is more important to me than worrying about a dying man's

potential addiction.

[ErikJ]

6. Hopefully he's not dying. He's trying to be optimistic as possible.

The chances from pancreas cancer arent good but he's a fighter and wont give up easily. He starts chemo soon.
He's a vet and is getting all this 100% free. He is very impressed with his care so far. great doctors and nurses. They sent him home but is still on liquid intravenous food. The VA nurses come to visit him twice a week to check on him.

[PasadenaTrudy]

20. Pancreatic cancer

is one of the most lethal cancers. No one recovers from it, sorry to say. Lost my sis to it.

[RiffRandell]

9. Exactly. nt

[Warren DeMontague]

14. Right, the threat that someone might get an unauthorized buzz is more important than

pain management.

This message brought to you by the DEA and its $60 Billion dollar a year gravy train.

[kcr]

18. I really hope your friend was just humoring you

And continued taking his meds to treat his pain. Otherwise, shame on you.

[ErikJ]

24. I dont think so. I was surprised too.

He apparently must not be in that much pain. He said a few times he doesnt like the pain killers anyway bc it makes him too tired. Go figure. Same with beer and wine. But he sure liked his hard liquor. Every few weeks he'd buy a bottle and binge drink most of the bottle. I think that may be why he got pancreas cancer.

[kcr]

25. Well, that's good he's not in much pain

I hope your friend has a full recovery.

[cali]

35. I find your posts in this thread about your "friend"

really disturbing and dispiriting. I put "friend" in quotations, not as a sign of doubt that this person exists, but because, yikes, you're incredibly disparaging of this supposed friend.

I'm just gonna stop there.

[ErikJ]

38. Ha. Give me an example of how I disparaged him.

I said he was optimistic, a fighter, and loved his vet care.

[cali]

41. .......

But he sure liked his hard liquor. Every few weeks he'd buy a bottle and binge drink most of the bottle. I think that may be why he got pancreas cancer.

[ErikJ]

42. No insult. Just a fact.

That was his one vice. Occasional binge drinking of a fifth of liquor. He didnt even smoke or drink beer or wine. I did a google and one study said that people who drink liquor have a higher chance of pancreas cancer and even more for binge drinkers.

[Maraya1969]

22. And my friend's 94 year old mother is being refused opiate drugs by her

because she is afraid her mother will get "addicted"

It is fucking out of control!

[progressoid]

39. At 94?

Gee, an addiction could really hurt her future!

If, I make it to 94, it will probably be because of drugs.

[elehhhhna]

28. We havea teen friend in recovery who battled osteosarcoma

-- she's clear now but thinking about having the leg off b/c otherwise she will have to start oxy (other meds wear off) and she's got addictbrain.


tough choice.

[ErikJ]

29. This is the documentary I watched: OXY HELL (Oxycontin... the gateway to heroin)

scary stuff

[elehhhhna]

30. the addict kids around Houston aren't doing oxy much

booze, meth, Xanax (huge), heroin (snorted mostly)

[Comrade Grumpy]

5. This is largely a consequence of the war on drugs.

Better that people suffer in agonizing pain than somebody gets high somewhere.

[KrazyinKS]

7. The problem is...

People take it when they have no pain, the drug manufacturers have to be making a killing. My father-in-law died of liver cancer like 6 months ago. I know my sister-in-law was there and she said he was moaning from the pain. So she had to go to the nurse and ask for them to give him something, I forget the term she used. She told me you have to ask for it, pain meds, they don't volunteer it. It does seem to me if you have stage 4 cancer then it might be a good time to become a drug addict, but maybe not until then. Although back pain can be debilitating, but not deadly. Hmmm. it's a tough call.

[sorefeet]

8. My brother Pinkie died

from Liver cancer. He told the doc he was in pain, but before he would prescribe, Pinkie was required to talk to 7 different doctors on 8 different appointments, it took over 2 an a half months and then the doctor prescribed LYRICA, a fucking drug for neuropathy.
YOU GOD DAMNED SPINELESS FUCK, YOU WERE MILKING THE SYSTEM AND YOU ARE A FUCKING COWARD. YOU ARE NOT A DOCTOR YOU ARE A FUCKING PUPPET. It's OK though you spineless fuck. I got him illegal morphine off of the street, while we were waiting for your incompetent decision. I trust you, like I trust a cop.

[RagAss]

13. Amen !

[idwiyo]

40. Hugs. I am so sorry for your loss. Thank you for helping your brother to get painkillers anyway.

Arseholes who do this to people in pain are torturers.

[lonestarnot]

47. That is horrible! I am so sorry that you and your brother had to go through that.

[Humanist_Activist]

10. Honestly I don't get it, especially for pallative care, if someone is dying, then give them the...

fucking drugs so they aren't in so much pain and suffering, we don't even treat animals, in most cases, this horribly, this is just a travesty.

Even those who may not die should be given what is safe(so no ODing) to alleviate pain, then, if they get addicted, deal with that, later, after they aren't dying or in extreme pain anymore.

[BlueJazz]

11. What you say is oh so true. I was thinking, lets give the people who are in terrible pain, Pliers.

When the Doctor says "No Drugs", the patient can squeeze the Doc's finger with the pliers and say "It hurts like this"

[Warren DeMontague]

15. Instead we have doctors terrified of the DEA, and people dying in screaming agony.

Because we have to stop teh drugggggggggggggggz

[CFLDem]

16. My grandfather recently passed from cancer.

Rest assured we got him so many drugs he was not on this planet when he passed.

[Holly_Hobby]

12. My DOG got more pain relief than my mother in law

who was dying of ovarian cancer.

My dog had mast cell cancer and was taking triple doses of Tramadol in the end and was in no pain whatsoever. My mother in law was wailing in pain at the end and they said she had the max she was allowed. HUH? She's dying, for christ's sake, just give her the damn shot! So what if it hastens her death? No one could give a good answer.

[RiffRandell]

44. That is absolutely insane.

Tramadol isn't even a narcotic pain killer. I am so sorry. I do believe there are doctors who will "give extra" to put someone out of their misery...it's just not broadcasted.

[MoreGOPoop]

17. Effin A Finally!

The Cruel Corporate Cages, Inc. have so much control that even
(especially) Veterans cannot get what they need. It's a gd shame.

[Hekate]

19. Cancer used to be the most dreaded disease not because of its death sentence, but the pain

The fear of dying screaming and helpless haunts us still, and with good reason.

Gods, we're stupid sometimes.

[OwnedByCats]

23. This is just terrible

Especially in cases of terminal cancer. This subject is very close to home for me.


You've got the DEA breathing down doctor's necks, so many people either not medicated or under medicated, then when you are given them for pain over an extended period, instead of weaning you off the drug so the withdrawals aren't so bad they cut you off, again afraid the DEA will go after doctors for prescribing to an addict or dependent person. Guess what happens when doctors cut people off? Some will go to the streets to get the drug. The DEA have not helped this problem by making people decide to suffer pain and withdrawals or break the law. You are always better off to have your drugs managed by a competent doctor than a drug dealer. I suffer from chronic pain, but I can't get anything. When I lived in England, my doctor gave me what I needed and I had no problems and my quality of life was so much better. I came back home and couldn't get anything and I have been suffering since. I was dependent, but not addicted, hence why I never went to the street. I just suffer and have a horrible quality of life because I don't want to break the law, just because some people abuse them and society deems it now unacceptable to help your pain, even if you did so responsibly.

However, not everyone has the willpower I have, or they are addicted. So they go out and buy drugs off the street which could end up killing them - heroin being purer in some batches than others which ends up an overdose because they didn't know what purity it was. You could buy OxyContin, but how do you know they are actually selling that to you? It could be rat poison for all you know. Then you take the chance on getting arrested or be in the wrong place at the wrong time and end up dying by a gunshot wound because your drug dealer was involved in a turf war with another or something like that. You have to associate with some pretty shady people which is dangerous in itself.

Too many regulations on prescription drugs and the drug war on street drugs has done nothing to curb addiction, if not make it worse. It's always going to be a problem unless we deal with it in a better, smarter way. Helping those dependent or addicted instead of cutting them off would be a start. Believe me when I weaned off the drug, the withdrawals were much more tolerable than if I had stopped taking them at the dose I was on. Now doctors don't even want to cooperate with that. They just wash their hands of you. Responsible people end up suffering and all the while the addicts are still going to get heroin or OxyContin no matter what. People are always going to do stupid shit that can get them killed. Some people are alcoholics, but we can still buy alcohol everywhere. Oh but an essential pain med for chronic pain or palliative care? Forget about it. We even have some places more open minded about pot, but chronic pain sufferers who either find pot doesn't help their pain, they get bad effects from it or it's not legal - it's just too bad.

Once you understand why you become dependent/addicted to opiates, it makes perfect sense as to why it happens. There are ways to treat this issue but doctors feel like they can't do so adequately without putting their license to practice and their livelihoods at great risk.

My dad has severe arthritis in his hip (it's bone on bone now), he needs a replacement but it could be a while due to another health issue that needs to be resolved before he can have the op, in the meantime he's under medicated and miserable from the pain. This is not acceptable.

[Trillo]

26. A FDA blast from the recent past

FDA Recommends Tightening Access To Hydrocodone Pain-Killers
http://www.democraticunderground.com/1014630710

Also, seems related,
FDA approves drug 10 times as potent as Vicoden
http://www.democraticunderground.com/1014636594

In the 1800s, we could have just bypassed the Healthcare corporation$ and bought a bottle of opium. Supposedly, the idea of the limited time for patent protection was that it would improve society after giving the inventor a limited time to profit. Now, the old, inexpensive drugs are just regulated out of existence, and to get the more expensive replacements still under patent you have to bribe a lot of different entities.

[MiniMe]

27. My mother died from Colon cancer at the beginning of the month.

She didn't have much pain until the last few days. She was under hospice care, and when I called and told them I couldn't control her pain with the drugs that I had for her, they moved her to the hospice facility. I can't say enough positive things about hospice. They sent a nurse to see her every day, and they gave her subcutaneous dilaudid when she got to the facility. Everything happened very quickly towards the end. She went from being fine and able to drive herself around, to the hospital and it was about 3 weeks when she died. It was a recurrance of the cancer, but she had a lot of metasticies (not sure I spelled that right). I was glad for her that she didn't have to suffer too long.

[elehhhhna]

31. hospice is the place for paincontrol

at home or otherwise.

[Th1onein]

32. In the book, "Three Felonies a Day," this is one of the groups targeted by the Feds.

They want to shut up people who are fighting for a sane policy on pain medicaiton.

[Laelth]

33. k&r for the truth. n/t

-Laelth

[RiffRandell]

34. My husband had oral cancer and his drs were very generous

with pain meds. I can't say enough about how great they were. The treatment of oral cancer burns your throat and mouth so he needed a feeding tube. They started out low and would ask him or I would call and they would gradually change/increase them so by the end he was on the heavy duty stuff. That was almost 7 years ago, so maybe things have changed and that study seems to be addressing other countries (not that I can't empathize and think it's disgusting) but if any oncologist is being stingy I'd tell them to fuck off and see another doctor.

When someone is suffering a large amount of pain, they don't get a buzz off the drugs (unless they over-indulge) as they attack the pain. When my husband would take a new, stronger drug I remember him getting a buzz initially but it wore off pretty damn quick.

I have chronic pain myself and go to the pain clinic at my hospital and (knock on wood) never had a problem....if I did I could barely get out of bed in the morning.

Don't be afraid to ask doctors for meds! That's part of their job.

ETA: If someone is terminal, they shouldn't feel ANY pain.

[jsr]

36. Drug Seekers Suck

http://www.epmonthly.com/whitecoat/2008/02/drug-seekers-suck/

Drug Seekers Suck

... A lady with a previous history of chronic neck and back pain now comes in with frontal headaches for the past month. Of course, her pain is a 10 on a 1-10 scale. She gets dizzy at times when she stands. Sometimes she gets nauseous. She says that she has vomited twice in the past 3 days. She used to take Vicodin for her back and neck pain, but she’s out of them now. I look through her old charts. She seems to like Dilaudid and Vicodin.

It’s a busy shift, so she had to wait for a couple of hours. When I walk in the room, she’s laying on the bed with her arms folded. She seems upset with the wait, but she’s playing the “nice” card, I can just tell. She’s sizing me up from in between those fingers over her eyes. Very polite. Says “thank you.” Compliments me on being so nice even though we’re so busy. I engage in some small talk with her and she actually is a nice lady. The little voice in back of my head is literally kicking me in the mastoid right now. “Hey! WhiteCoat! Don’t be a sucker. She may be nice, but remember her history! Being overly “nice” is page 2 of the drug seeker’s handbook!”

Since her headaches are a “new” complaint, I examine her from head to toe. No fever. No sinus pressure. No temporal arteritis. Fundi normal. No photophobia. No meningeal signs. No abdominal problems. No focal neurologic deficits. Oh, by the way, she still has that chronic pain in her back. Can’t find anything abnormal on her exam other than her “10 out of 10? pain.

I don’t care how nice she is, she isn’t getting Dilaudid. We give her some Phenergan for her nausea and some Imitrex for her headache. Her headache improves to a 5 out of 10. ...

[CrawlingChaos]

43. I would have tiltled that article "shitty ER doctor makes excuses for his terrible judgment"

It's horrible what that woman went through, and patients should be able to seek help for intolerable pain without being treated like criminals. The benefit of the doubt should be given to the patient. This crappy doctor's excuses are bullshit, and his after-the-fact "concern" is underwhelming.

[Sheri]

37. the doctors have gone crazy on this.

not sure what they're afraid of ... lawsuits, perhaps ... but people in pain should not be denied relief.

[Egalitarian Thug]

45. It's not the doctors, it's the DEA. They record every prescription, especially those for pain,

Last edited Sun Dec 1, 2013, 10:57 AM - Edit history (1)

and doctors that write a lot of them are visited and audited, regularly. They can and have closed down pain management practices all over the country, and short of that, no doctor wants that kind of hassle in her office.

Big Brother is watching,

[Sheri]

46. didn't know that. thanks. nt